Tuesday, September 30, 2008

Operation Grow Something and MaddyWatch--two updates for the price of one!

Our computer may be hosed here at home, which is going to make blogging a little difficult, to say the least. Hence, this will be a very brief update of life at the HKH.  The top photo is Maddy and Hazel doodling around the feed-me-Seymour tomato plant on the balcony.  It's in the 70s here in Denver, so it turned out to be a nice day to hang out on the balcony.  Maddy took her first dose of chemo on Friday and will take another tonight.  So far so good. She's also able to whoop Lulu's ass when she bothers to stick around to engage her.  Hazel's surely at least 1.5 lbs heavier than Maddy, but Maddy still rules.

The bottom photo is what's left of the tomato plants.  Parts of them have gone brown, thinned, and died a bit, but they're still doing well.  It's as if the onset of fall has brought out the tomatoes in full force.  The grape tomato plant has always been producing, but it's made a lot of little red tomatoes lately, which Guy and I are putting in chili and on greek pizzas.  The Roma tomato plant has become a maniac, maniac on the floor and it's grow-ing-like-it's-ne-ver-grown-be-foooor.  [running in place in the kitchen with a wooden spoon and legwarmers]  I'll be able to pass some tomatoes on to some coworkers, so it seems.

Anyway, I'll cross my fingers for the computer.  It sucks because I really try not to blog while I'm at work, just in case, y'know?  I don't want anyone to have ANY reason to lay me off, after what happened last week.  Meanwhile, many of us who are left are assembling their resumes and project info sheets just to be safe.  You never know--our coworkers have been calling and emailing us like crazy to get pictures and info on projects for their resumes, and none of the left behind crowd wants to be in that same position.

Sunday, September 28, 2008

A swiftly falling ax

Last week, Design Associates laid off ten people in one day. Before now, we'd laid off a couple people here and there, mostly people who weren't being terribly helpful or had had performance issues. But last week, it was ten fairly decent people, including my pal Ethel and longtime pal and CAD manager Sarge. Wanda was also sent away, much later than she should have been in my opinion, but alas....

The people were laid off just before lunch, and then we had a staff meeting after lunch so that the partners of the firm could explain what was going on. They said they lamented having to do it, and they'd put it off for almost two months. To DA's credit, they tend to be among the last people to lay folks off. I think us and another firm had big layoffs last week, but that's all I've heard. Most other firms in town did their layoffs in the spring or even summer. It blew me away to hear of Sarge's layoff--he's really the only person who can answer the tough CAD and Revit questions, and I can guarantee you that there's going to be more problems in the office with software now that this happened. Sarge emailed me today to ask if I could get him some images of projects that he'd worked on, and Ethel already sent me her resume to look at and help her tweak.

Guy's office just got really busy. His office of his firm (they have offices in other cities) has gotten the job to do the construction documents for part of a big hospital back east, so they may need to hire another person, maybe two, but there's no way that his company can absorb DA's loss. Meanwhile, Ethel emailed me part of a wanted ad online; it was for a healthcare architect with 7-10 years experience (just like me) in an office south of town...with a starting salary of $80K. That's a sight more than I make now. I wish she hadn't sent it to me. I know I'm underpaid at DA but I hate being reminded of how underpaid I am. I really like the people I work with, and to an extent that makes up for a certain amount of money, but still.....

Friday, September 26, 2008

The (wo)man wit da masta plan

We’ve been master planning for a small hospital east of Wheatlands, and we just had a sit-down with a contractor who will price the master planning options that we designed. The little hospital presently has two buildings—one from 1970 and one from 1991—that are connected one right to the other. They need to update their facility in order to better treat patients as well as get new patients and expand their services, and they need to know what expansion plan is the best bang for the buck. Howie and I ended up with four options for them:

  • Keep the existing buildings and just remodel parts of the 1970 building in stages in order to meet building and healthcare codes.
  • Add onto the 1991 building and keep it mostly intact; remodel part of the 1970 building and demolish the other part.
  • Add onto the 1991 building and keep it mostly intact; demolish the entire 1970 building.
  • Build an entire new hospital and ditch both old buildings (sell, give to the city or county for their use, whatever)

We come up with some really schematic plans of how this would look, and the contractor figures out a per-square-foot cost for those options. A schematic plan involves rectangles and shapes filled with color and big print in them: Kitchen, Clinic, ICU, Surgery. There are no doors our countertops or beds or equipment or any of that drawn in, just general sizes and shapes. And it’s not just plopping down some colored shapes and calling it a day—the shapes have to be laid out so that it’s somewhat buildable as well as useable. For example, we have to show the imaging suite in close proximity to the emergency department as well as the clinic so that patients from either can easily get an x-ray or a CT scan. Another for example is working out how people arrive at the patient room wing—a visitor should have to walk past a check-in desk of some sort before they get to a patient room.

The schematic plans also have to be able to work on at least a general level with building, ADA, and healthcare codes. For instance, hallways in inpatient sleeping and treatment areas must be eight feet wide. Hence, when Howie and I are plopping colored rectangles onto plans, we have to make sure that we allow eight-foot-wide spaces to get through and between them. Also, the various codes require that any patient room has to have a window in it, so when we’re a-ploppin’ spaces, we can’t just smoosh the Clinic up against an existing outside wall of a patient wing because it’ll block the windows. Also, building codes require that if exterior walls of buildings are within a certain distance from each other, they have to be fire rated, and that includes the glass in the exterior windows. Fire-rated glass starts at $100 per square foot. So, putting some space between new and existing exterior walls can save you money in construction costs.

So, there’s a method to our really-schematic madness. It looks simple, but we can’t just draw some circles and squares and color them in and tell the contractor ‘vaya con Dios'. After the meeting today, we realized that we need to check into a few more concerns, such as:

  • At what point of a remodeling project do you have to update everything in a building? Is that amount/standard the same amongst all the codes?
  • How much of the building can be a business occupancy versus an institutional occupancy? Business occupancies require much less fireproofing and mechanical/electrical stuff, so they're generally cheaper to build than an institutional (hospital) occupancy.
  • How much of the existing building is really out of compliance with present codes? If we make a plan and bullet-item list describing what's noncompliant, we can show that to the owner later on down the line when they complain about costs or get frustrated with the process. They'll say "why are we doing this shit again?" and we'll pull out the plan and the bullet list and say, "This is why; because we have a 30"x42" plan and a seven-page list of stuff that's against code in your old building, that's why."

Hopefully, we'll have pricing back from the contractor in a couple of weeks, but we'll see. What's been frustrating about all this is that we let the owner really beat us down on fee, so we've run through our fee but there's still work to be done. So, in one breath Howie says, "Look this up, do this, draw this," and in the other breath he says, "Don't spend a lot of time on this." Mmkay. Which one is it? As Liz used to say while working on Pomme de Terre, it takes as long as it takes to do a job right. No one's dragging their feet or piddling, but dammit, good work takes some time. However, I've only got a couple more days to get some stuff together for the contractor on this, so I guess the pressure's on.

Wednesday, September 24, 2008

Birthday Pixie and Guy

Happy birthday to Guy and me! Today we turn 40 and 33 respectively. This year we're celebrating low-key, just a nice dinner (my present to Guy) at a restaurant without a TV in it (Guy's present to me). Usually we give each other a trip somewhere, but we decided to save our money and vacation time for a trip to Yellowstone next year. Regardless, I'm lucky I get to share my birthday with a partner that can tolerate my bullshit and occasionally call me on it.

Tuesday, September 23, 2008

Work versus time

I read the book Why Work Sucks and promptly tossed it aside with the thought that it sounded like a good idea but I didn’t think it would work for my particular profession. The book’s authors describe what they call ROWE, the Results-Only Work Environment, which is something they came up with and put into place at Best Buy’s corporate headquarters when they worked for Best Buy. The simplest description of ROWE is that you work wherever, whenever, and however, as long as the work gets done. The idea behind it is that companies have to stop watching the clock and hassling people about how long they’re at the office, because ultimately if you work a white-collar service-industry job, you’re being paid for your work, not your time. The more I started talking to Kellye about it, though, the more it started to make some sense. I then bought the book and reread it, and my head exploded. Between reading that, learning about Dzogchen meditation in a book by Lama Surya Das, and realizing that yin and yang forces in the Universe are really manifested in Gary Busey and Nick Nolte, I nearly passed out from having a spiritual revelation.

When I recovered and had some vanilla hazelnut coffee from Einstein’s (which will be the official beverage of my regime when the revolution comes and I rule the world), I turned over the concept of hourly versus salary in my head. Most architecture firms pay their people salary, but Design Associates pays interns and non-associate architects hourly while associates and partners are paid salary. DA also pays its design staff bonuses based on project profits, which is kinda unusual for an architecture firm. In the past, I’ve often told interns that being paid hourly is a good thing, as it prevents abuse—that is, your salary doesn’t suddenly become based on a 45-hour or 50-hour week, which happens a lot to interns. Also, being paid an hourly wage means you get overtime for anything over 40 hours. This was really nice when I was working 56- and 60-hour weeks for eight months on Wheatlands. Some of the cash I made doing that stuck around in my savings account, and I was able to use it on Maddy.

With work being slow, however, the hourly thing is killing me. I have to work my ass off to find something to do to fill 40 hours, and most weeks it’s more like finding 32-35 hours’ worth of stuff to fill 40 hours, which leaves me feeling a little guilty at the fact that I know I’m overbilling to a project a little. Now, on the one hand, I could just work 35 hours and bill 35 hours and have a short check. That action would only cleanse one portion of my conscience. The part of my conscience that would be furious is the one that knows that I, along with several of my colleagues, am very fast, efficient, thorough, and great at what I do. If I can finish an eight-hour task in six hours and with excellent quality, why must I be punished for my efficiency by having to find something else to do for two more hours?

When I posed this question to Guy, his response was, “There’s always something else you can do.” Well, number one, no there’s not. Not lately at my office. I’ve had days where I’ve sent out emails to at least a dozen managers in the office letting them know I’m available as of now to help, and I get no response. And then, number two, by Guy’s logic an employee should never leave work because there’s always something else to do. No one’s inbox is ever empty. At some point, you should be allowed to go take the cat to the vet,, take yourself to the doctor, go buy groceries, go rock climbing, go see your kid in his or her soccer game or school play, whatever, without guilt. Instead, you have to do all that stuff on your only two days off, which are the days you’re supposed to be resting. Frankly, we’re still applying Industrial Revolution-era concepts about time to the Information Age workplace, and it’s falling a little short.

On the one hand, motivated and interested employees will finish an eight-hour task in six hours and then look for more things to do, more ways to help, and so on. On the other hand, finishing an eight-hour task in six hours means the employee gets “rewarded” with more work. Myself, I’ve found in the months and years since Wheatlands that if I work less than eight hours of overtime, I’d rather take it as comp time, and I do. Even when I think about Wheatlands, I realize that I didn’t work all that overtime because of the money, but rather because the work was there and it needed to be done and I was the only one available to do it. And many of my colleagues—Derek, Kellye, Norman, Ingrid, and Elliot—are the same way. They’ll do the work because it needs to be done, not for the overtime, and they’d rather have time off than overtime cash.

I’m still turning all this over in my head. I realize that all this is probably more suited to Ms. Theologian’s blog than mine, but I think about it now and then. I don’t know that I’m ready to roil the waters at DA with this sort of talk, what with the economy being in the crapper and all, but I think it’s worth dissecting at some point.

Sunday, September 21, 2008

Think of the children

We decided to go with the at-home oral chemo for Maddy. Dragging her to the vet oncologist’s office once a week for 8 weeks plus once every two weeks for four months for the IV chemo doesn’t sound like a good deal for Maddy. Never mind the fact that the IV chemo is more than twice as expensive; it only adds 6 months to her life versus the at-home chemo. I’d rather her be comfortable and healthyish at home for less time, and no, I’m not willing to just let her dribble off with what’s left of her life. As I type this, she’s in my lap nomnomnomming on my right wrist, as she’s wont to do when I type. This morning, she and Hazel got into a pitty-pat-pat fight in the floor which ended in Maddy actually jumping on Hazel’s back and chomping down on her neck, like she used to do before she got so sick. Lulu mrowr-rowr-rowr!ed and scampered off, prompting Guy to laugh and me to holler after her down the hall, “Lulu, you got pwnd!” It reminds me of my sister and me. She’s two years older and was therefore bigger for most of our childhood, and inevitably she could throw me off whatever bed we were wrestling on. Even as teenagers when we were evenly matched and even when I had a 20-pound advantage on her, she could still throw me off the bed. Even as 20-somethings when I weighed a little less but had a lot of muscle, still ‘twas my ass flying into the floor. When Kitty visits in October, I want a rematch.

I called Mom last night and caught her up on Maddy’s progress and our decision on the chemo. She was glad to hear about Maddy still being fairly frisky for a 10.5-year-old cat with cancer. We chatted on about various topics, and we somehow got on the topic of these damn kids with their short attention spans and inability to entertain themselves without a television. I thanked Mom for not having the TV on a whole lot when Kitty and I were small—I really think it made a difference in our cognitive abilities and our academic and professional success in general.

“That TV not being on was your call,” Mom said.


“I used to watch soap operas,” explained Mom. “On one of them, there was a car wreck in which a baby was badly hurt, and it lingered and was in the hospital, and they’d even show it sometimes with tubes and wires hooked up, and the characters were always talking about what to do with the baby and if it was gonna live, and I think it eventually died, but…you were just a little thing, and you’d sit there and ask me ‘Mama, why did they do that to that baby? Why did they hurt that baby? Is that baby gonna be okay?’, so I cut it off. Some of the other women I knew would talk about soap operas, and I’d say ‘I don’t watch them anymore, they upset my children and I can’t have that’. So, after Sesame Street and The Electric Company, that TV went off and stayed off.”

Well, we must think of what’s best for the little ones in our care, whether it’s the TV they watch or the medical treatment they should have.

Tuesday, September 16, 2008

Scylla, Charybdis, and Maddy

The vet oncologist had okay news, but nothing spectacular. While lymphoma is common in cats, Maddy's has advanced somewhat--it's in her lymph nodes and not just her intestine. We can do an oral chemotherapy at home, or a more aggressive IV chemo at the vet oncologist's office. That would be taking her to the office once a week for 2 months, then every other week for another 3-4 months. Optimistically, she might live another 6 months symptom-free after the 6 months of IV chemo, then it'd be a one- or two-month downhill slide ending in euthanasia. I don't know what our results will be like with the at-home oral chemo pill, probably darker/shorter. The IV chemo is also about $4,000 total over the 6 months, the at-home pill less, but I don't even know how much less.

Guy and I haven't really talked about it yet. I told him what the oncologist told me, but we haven't had the should-we shouldn't we discussion. Probably tomorrow during our walk--it's the kind of talk that needs to happen when you're kinda doing something else, like driving, which is when we usually have our deep discussions. However, Guy started going for walks with me after Maddy first got sick. I just needed to get out of the house, and Guy would go with me to walk and relieve some anxiety.

Guy is frankly a bit hit-and-miss on the consolation. When there's something he can do, he's pretty helpful. The walks, for example. Also, he's bought dinner or had us end a weekend morning walk at a breakfast place now and then, which is a relief of mroe than one level, for sure. He's been kind to Maddy, and he even--and I have to be honest, this surprised me--offered to help with Maddy's vet bills. But the actual consolation is, well...at the emergency vet's last week after Maddy crashed post-biopsy surgery, I was shaking and weeping in the waiting room. Guy patted my knee with one hand, and I felt him twitching a little. I looked over, and I realized he was playing Tetris on his cell phone with the other hand. He's playing fucking Tetris while I'm losing my mind from panic and fear and grief just 3 inches from him. I'm finding that if I'm shaking and weeping, he has no idea that he needs to put both arms around me and hold me and pat me and say something kind like "I'm sure we'll make the right decision" or "Whatever happens, Maddy won't suffer and you've done a good job." But if there's something to be done, like active doing, he's right there and almost psychic. Perhaps in another eight years I'll have trained this quasi-autism out of him.

So, we're weighing our options. Either way, Maddy has to take prednisone for the inflammation caused by the cancer cells. The conversation with the vet oncologist went thus:
Vet: So, prednisone is a type of steroid, which will help Maddy gain weight.
Pixie: But...will it raise her batting average?
Vet: [pauses, then bursts into laughter] I don't think it will, sadly! Is she any good on the field?
Pixie: Look, if she can bat at least .250 and play right field, I'm sending her to the Rockies. They're not doing too well this year.
Vet: Well, prednisone isn't that kind of steriod. She'll just gain some weight, and she may even balloon a little.
Pixie: [eyes wide] Like Jerry Lewis? Puffy-ass Jerry Lewis?!
Vet: [leaning on exam counter with laughter] Yeah, more like Jerry Lewis!
Pixie: [looking at Maddy on the table] Maddy, you can have your own telethon now!
Vet: [sits down on stool, laughing]

Sunday, September 14, 2008

In other news...

With all the Maddy drama, this blog has had quite the dearth of architectural commentary of late. However, the recent news does explain to a great degree why this architect drinks, anyway. More news in architecture on a personal level has been happening lately, and I suppose much as Shakespeare would follow an intense, dramatic scene with a lighter and more comical one, I should follow The Bard's lead and provide some similar narrative relief for the WAD-reading public.

First, Guy. Guy's architecture office is a branch of a nationwide architecture firm that has been in Denver for a few years, and their first big project (which caused them to open the office in the first place) wrapped up just as Guy joined their firm. He then spent most of the past year and a half being almost unbillable--he would occasionally get to work on a marketing proposal or design, but spent a lot of days reading architecture articles online, trying to stay sharp while staying bored. He billed a lot of hours to "Overhead," and it made him absolutely insane. Recently, though, his office got two pretty big projects. One is a clinic on a Native American reservation in Arizona, and the other is a large hospital somewhere back east. His office will be doing three floors of the overall hospital, mostly D&T areas (diagnostic and treatment, that is: stuff like surgery suites, imaging departments, procedure suites, chemo treatment suites, physical therapy, etc.), and another office of his company will be doing the patient floors of the hospital. Guy is about to be very busy, which is just how he likes to be. Also, he'll get to do an imaging suite, I think, which is good experience. Every good healthcare architect should have the chance to work on an imaging suite and get to see what it takes to put in an x-ray machine, a CT scanner, an MRI, and so on. I must say that as a healthcare architect, knowing what goes into making a hospital tends to make it easier to be in one, say, laying in the ED with a sprained ankle.

Second, I've been helping Howie with a master planning project for the hospital in a little town near Wheatlands, KS, where my last big project was. It's interesting to say the least, this master planning thing. Hospitals, like colleges and other institutions, often hire architects to help them develop master plans to decide what they should do with their facilities in the coming 5-15 years. What we do is look at their existing facilities--the building itself, the spaces, the mechanical, plumbing, and electrical systems--and also look at their financials and their utilization statistics (how many of what kind of procedures do they do each year? where does their business come from? what zip codes?) and then help them see what they could and should be doing with their business. We work back and forth with them to give them something they can live with, as well; we check in with the senior administration and the hospital facility board intermittently to ask questions, and if we make a suggestion that goes against thier mission or values or might cause them to lose funding or accreditation, we revise our assumptions and go back to come up with a better plan for them.

Often, we'll also come up with some very schematic plans for the future of their buildings, which usually involves three scenarios: one, remodel the existing building in place; two, build an addition to the existing building, which may or may not include some selective demolition; and three, build a whole new building. We get a few engineers on board to write narratives to describe what they saw in the existing building and what it would take to do each of the three scenarios. We give our narratives, the engineers' narratives, and our very schematic plans (which usually look like a bunch of colored rectangles) to a contractor or a cost estimating company, and they figure out what each of the three options costs. Finally, we present all our info, including the cost estimates, to the owner, and they can decide for themselves what they want to do with their building, if anything.

It's a slow process, but it makes sure that a facility is doing the right thing with their space and their money. Many facilities, for example, just want to renovate in place: a little face-lifting here, a little remodeling there, and oh it'll all be fine. What they don't realize is that the construction and facility standards for healthcare has come a long way in the 30-50 years since their building was built, and if we face-lift your interiors, you'll spend $240/square foot and still be left with basically the same thing you had before you spent a crapton o' cash. So, we run the number for them to say, "Look, for the same price per square foot of renovation, you can have a brand new x, y, and z. How 'bout them apples, yo?"

Sadly, in order to get the gig, we let them beat us down on fee, so as of late Wednesday, I had to stop working on the project. So I spent Thursday and Friday helping marketing with a few things that aren't supposed to last past about Monday or Tuesday of this week. However, I'll be at the vet oncologist's with Maddy on Monday morning, so there's a few hours taken care of. I emailed a bunch of different project managers and associates on Thursday and Friday, letting them know that I was very available and needed work if they had it. Hopefully, I'll actually have something to do next week. Now, Guy and I are trading places as to who's busy and who's not. This is when being paid hourly sucks--it's great when you're working mad overtime, but not so great when you've got not a damn thing to do.

Friday, September 12, 2008

MaddyWatch: Lymphosarcoma; good for Scrabble, but not good in kitties

The biopsy results came back that Maddy has abdominal lymphosarcoma. It's in her abdominal lymph nodes and her intestine but not her liver. Yet, anyway. I talked to the regular vet again today, who says that even though lymphosarcoma is described as "small cell lymphoma", which usually responds well to chemo, that fact that it's in her lymph nodes may not bode so well.

We have an appointment with the vet oncologist on Monday, but I can't say that I'm terribly optimistic. The main thing is that we'll need to discuss what chemo would do for Maddy, if anything, and if it would even be worth it. According to the vets we've talked to so far, chemo in pets isn't what it is in people. Vet chemo is more about quality of life, not stomping the crap out of the cancer like it does in humans.

So, Maddy has cancer. My sweet 10-yr-old kitten has cancer. I've rather been expecting it ever since the emergency vet told us what she saw in the abdominal ultrasound back over Labor Day Weekend. I'm disappointed but not surprised. What annoys me lately is how many people keep telling me not to unnecessarily prolong Maddy's life because I may not be ready to let her go, don't put her through pain, and so on. The constant yammer of "do what's best for Maddy" has me going Yeah-yeah-yeah-yeah-yeah-yeah-yeah-Igotit. Like anyone who would have her cat's teeth cleaned wouldn't do what's right for the poor creature. The best advice I've gotten so far was from Ethel, who had a similar experience with her own cat. She said to look at your pet, really look at her: she'll tell you when she's ready.

And so far, Maddy doesn't seem ready. She's slower than before, for sure. But in terrible pain and ready to die? Not so much. Though the balance of power has shifted in the house and Hazel pushes her out of the way now and then--and that's hard to watch--she's still not done. And again, I have to be able to look Maddy in the eye when she's in pain and tell her I've done all I can do. If chemo's not gonna help either give her some more quality time or make her comfortable, then we're not doing it. Yes, I know if she was in the wild, she'd likely be dead by now, probably because the rest of her pack would have left her or kicked her out. But I'm her pack right now. Me. And I'm not kicking her out until it's clear that she's ready to go. So there.

I've had a bunch of meetings and stuff to do all week, and I have to help Dame Judith with some stuff tomorrow morning. After that, I can finally sit down for a while. Maddy and I spent some quality time reading Southern Living while curled up on the chaise together tonight, and there will be more of that this weekend once my chores are done. And we'll just enjoy each other's company, purring and chatting, snoozing and reading. We can enjoy whatever time we have left the same way we've enjoyed all the time we've had for the past ten-plus years: together.

Wednesday, September 10, 2008

MaddyWatch: No news is good mews, so far

Maddy spent an uneventful weekend at home, and the week has been pretty quiet likewise. Oddly, though, it seems that the pecking order has rearranged itself around here. For the past ten-plus years, Maddy has whooped Hazel's ass on a regular basis, as she's usually outweighed Hazel by at least three pounds. Nowadays, Maddy's clocking in around 7.6, and Hazel's likely over 9. Plus, I think Hazel smells illness on Maddy. As Rev. Kit has lamented, these are indeed mammals with instincts first, children with fur second, and it would seem that Hazel--dammit!

I had to break up a fight in the floor. Just as I was typing that, Hazel hissed and took a swipe at Maddy. A few days ago she even nipped a little clump of fur out of Maddy's forehead, right over her right eye.

But we still haven't heard how the biopsy came out. I'll report when I hear something. In the meanwhile, I have some interesting-ish daily architecture stuff but am too tired to go into it right now. Thanks again to all my peeps in the blogosphere who are sending good thoughts in Maddy's direction.

Saturday, September 6, 2008

MaddyWatch: the credit card ad you'll only see here

Overnight stay at vet hospital over Labor Day Weekend plus abdominal ultrasound: $1,500.
Abdominal multiple biopsy at vet's office: $1,667.

Another overnight stay at the vet hospital for fever and low blood pressure: $1,100.

All-day stay at vet's office and multiple blood tests and vitals checks: $70.

Hearing the vet say that your sweet 10-year-old kitten's vitals are normal and stable and she can finally spend the night at home on your chest, purring and snoozing:


There are some things money can't buy.

Thursday, September 4, 2008

MaddyWatch: Fever! in the morning; fever all through the night? Hopefully not.

Maddy had her biopsy surgery today, wherein the vet opened her tummy and looked at all her organs, plus took biopsies of her lymph nodes, liver, and a few places on her intestine. The vet told me that her lymph nodes were really enlarged, so honestly this was most likely cancer. The point of the biopsy results would be to tell us what kind of cancer. Her red blood cell count was really low, and they had problems with her blood pressure being too low, so they recommended that she spend the night--again--at the vet hospital. Did I want to come get her now or later?

Ethel met me outside with a box of tissues. I may not enjoy working on the same projects as her, but she's a very good friend, and that's how she and I need to stay. She consoled me some, then said, "With this kind of news, you're done for the day. Just go get her and take her to the hospital so you can relieve your mind."

So, I picked up Guy on the way to the vet's office, and we picked up Maddy and got her to the hospital in record time in early rush hour traffic. The whole way there, and evidently also att he vet's office, Maddy was friendly, occasionally chirpy, and annoyed by the IV stick still wrapped on her left front leg. She moved around a lot in her soft-sided carrier in my lap, occasionally peeking out to watch the traffic going by. A few minutes after we got there and they took Maddy into the back (they were expecting her), here comes the vet we saw over Labor Day weekend: "Maddy's fever is up to 106.2, and we're really worried about that. Her red blood cell count is steady but still low. Her blood pressure is still really low. We're gonna try to bring the fever down and the blood pressure up, so hang tight."

She came back about half an hour or so later. "Good news, BP is at 98; I want her in the 100s, though. Her fever's already down to 105.2, so that's a good sign." She further explained that in order to get her red blood cells up, she wanted to do a blood transfusion, and that tomorrow morning, Maddy would either a) stay with them to recover through the day, b) be transferred to the oncology department (yes there is such a thing for animals), or c) be transferred back to my regular vet to recover further through the day.

Let's not even think about the cost of all this. Here's the deal: when you take on a pet, you make a promise to care for this creature to the best of your ability. I am so far able to afford everything I've done for Maddy, and as we get a diagnosis and find out how far long whatever she has has progressed, we'll further evaluate costs. But ultimately, I have to be able to look into the eyes of the creature in my charge and say, "I did my best." I also know that only so much of what's going on right now is in my control. The whole time we were in the waiting room of the vet hospital, I just prayed and beseeched "Maddy, if you have to go, you can go, baby. I wish you'd stay with me, but you can go if you need to. Do what you have to do. Do what you have to do. Do what you have to do."

Do what you have to do. I suppose that's all any of us can be asked to do. I weep at the thought of waking up and losing her tomorrow. Granted, she was acting fine and she was stabilizing, but just as I was getting calmer about Maddy's situation, this happens. I was getting hopeful that she didn't have cancer, and now it's almost totally confirmed. Kellye, to his credit, commented that he bets Maddy isn't done yet, that from my descriptions of her she's only used up 3 or 4 lives so far. Ethel affirmed that in any endeavor, especially those involving the ones we love, we do your best and leave the rest to God. Guy has been semi-supportive in weird ways. On the one hand, he only put his hand on my knee as I wept and gasped bitterly in the hospital waiting room, and I sense that he completely disapproves for the money and time I'm spending on Maddy. On the other hand, he drives us to the appointments and does a fast and fine job, and he also has taken several walks with me over the past several days, just going with me when I need to get out of the house and get away from the panic gripping my stomach and head and eyes. So, I'm not yet going to get in his grill about some of his behaviors.

I'll keep updating as conditions warrant. I just pray for my little kitten and hope that she pulls through, and if not, that St. Francis and Bastet take her with gentle care and without pain.

Update, 9/5/08, 8:21am:
Maddy made it through the night pretty well. Her fever came down, her BP and her blood proteins and red blood cell count went up, and she even ate a little food. So, I took her back to her regular vet this am to spend the day, and if she can keep her values stable, she can go home tonight. Thank you to everyone with your good wishes!

Monday, September 1, 2008

Please, anything but this.

We spent the past weekend rushing Maddy to the emergency vet. She refused to eat and had lost another half-pound in a month. The vet said she was running a fever and was probably dehydrated, and given her history over the past 9 months of losing weight and being totally hungry, she wanted to perform an abdominal ultrasound to se what was going on in there. My regular vet offered to do this back in late July when we took her in for the severe weight loss (3 lbs in 8 months), but I guess I talked myself out of it, saying maybe she just really didn't like her new food from the vet's office.

The ultrasound revealed greatly enlarged abdominal lymph nodes, enlarged spleen, and some thickened loops on her intestine, which usually point to gastrointestinal lymphoma. We'll need to do a biopsy on her nodes, spleen, and intestine this week to be sure. The other option is this might be inflammatory bowel disease, but it's looking cancerish so far.
I noes I lost some weights, Mama. Hao abowt some moar treets!

Maddy came home fromt he vet last night with meds for a UTI (evidently, we're not giving her enough cranberry juice), and directions to get her biopsied. I have to go to a site visit three hours away from Denver on Tuesday in a place that might have spotty cell service, so I'm dithering between having my regular vet (who could do the biopsy) call me or call Guy. But simply put, I'm a wreck. My eyes and head and stomach and teeth hurt from all the crying I've done since 5pm yesterday. I can't stop crying when I look at her. I just sob hard, gasping for breath so that now even my throat is sore. I see her and suddenly some dreadful/sad/wistful song pops into my head and the tears come unbidden right on its heels.
[flapflapflapflap of ears while shaking head] Ehn! The vet hospittle wuz lowd! Glad to be hoam!

Granted we don't have the actual diagnosis of cancer vs. not cancer. The vet did say a couple of times "if it is cancer...", so on the one hand I suppose I'm jumping the gun with all the weeping and missing Maddy already.

*sigh* They shaved mai tummeh, my frunt rite foreleg, and a spot on mai nek. I needz a treet foar teh payn.

But I somehow can't help it. I'm not ready to let her go. Not at a spritely 10 years old, not when she's always been Miss In-Your-Face-For-Wuv-and-Treats. The house was so empty without her here Saturday night. But she sat on my lap last night out on the porch and snuggled while I attempted first to read and then to cry without annoying the whole neighborhood. I'm inconsolable, but I still want to be consoled. Guy isn't terribly practiced at this, but he's gettnig better. But I just can't stop crying when I think about letting her go over the Rainbow Bridge off to see Teddy, Dee-Dee, and Lewis before her.

Luk, if yr nto gonna mayk wif teh treets, i mus tayk matrz int2 mai oan pawz.

So, Maddy's at home, doodling around like usual for the most part. She walks a little funny, maybe the ultrasound, maybe from the UTI, but overall she seems okay. Her runny squirts reek to high heaven though, so everytime she uses the can, we have to scoop it (and sometimes wipe/mop it--she misses a little, but that's par for the course with her).

I'll go see Papa in teh othr room, kthxbai. He alwayz haz treetz!!1!!!

I guess for now we have the biopsy done ASAP and go from there. Meanwhile, it's wet food and treats and medicine for the next while. And as for this morning, I think Maddy and I will go sit on the porch and read the paper with some coffee and enjoy the nice Labor Day morning that's coming on in the Mile High Cit-tay. While I'm torn up to no end over this, Maddy just came into the computer room to remind me that there's more to life than blogging and crying and feeling sorry. As I was recently reminded, the only reason to feel sorry for a cat is that it has to use its tongue as toilet paper.